The contraindications for Raloxifene include individuals with a history of thrombosis, pregnant women, and patients with liver dysfunction. During medication, it is necessary to avoid high-fat diets and strictly follow restrictive conditions. The following are specific classification instructions and clinical precautions.

1 Taboo population

(1) History of thrombosis: Patients with active venous thromboembolism or deep vein thrombosis should avoid using this medication as it may increase the risk of thrombosis.

(2) Pregnancy and lactation period: It can pass through the placental barrier and be secreted into breast milk, which may cause fetal malformations and adverse reactions in infants.

(3) Abnormal liver function: It is contraindicated for patients with severe liver dysfunction (Child Pugh C grade) as the drug is mainly metabolized through the liver.

2 Forbidden Foods

(1) High fat diet: Avoid consuming foods with a fat content greater than 35% during medication, which may reduce the bioavailability of the drug by up to 30%.

(2) Grapefruit products: The furan coumarin contained in them can inhibit CYP3A4 enzyme, leading to an abnormal increase in blood concentration of raloxifene.

3 Restrictions

(1) Cardiovascular monitoring: Blood pressure and lipid levels should be evaluated before medication, and thrombus indicators should be rechecked every 3 months during treatment.

(2) Gynecological examination: Patients at risk of endometrial cancer should undergo regular pelvic ultrasound examination, recommended every 6 months.

(3) Combination therapy restriction: It is prohibited to use it in combination with systemic estrogen preparations, as it may antagonize the pharmacological effects of raloxifene.

4 Special precautions

(1) Preoperative discontinuation of medication: Medication should be suspended for at least 72 hours before elective surgery to reduce the risk of perioperative thrombosis.

(2) Travel restrictions: During long periods of transportation (>4 hours), it is necessary to intermittently move limbs to prevent the formation of blood clots.

5 Drug Interactions

(1) The impact of warfarin: may enhance anticoagulant effect, and INR detection frequency should be increased when used in combination.

(2) Kolacetamide: Combined use can reduce the absorption rate of raloxifene by 60%, and should be taken at intervals of more than 4 hours.